Shen Yuan, Shen Yun, Dong Zhi-Feng, Pan Ping-Lei, Shi Hai-Chun, Liu Chun-Feng
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China; Department of Neurology, Affiliated Yancheng Hospital, School of Medicine, Southeast University, Yancheng, China.
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Sleep Med. 2020 Mar;67:237-243. doi: 10.1016/j.sleep.2019.11.1251. Epub 2019 Dec 12.
Our objective was to explore the clinical characteristics of Parkinson's disease (PD) comorbidity with obstructive sleep apnea (OSA), explore the correlation between OSA and PD features and identify factors that are independent predictors of OSA in PD patients.
In sum, 239 PD patients were divided into two groups according to the presence of OSA (apnea-hypopnea index (AHI) score ≥5) (PD-OSA vs PD-non-OSA). Blinded to sleep apnea status, participants underwent an extensive assessment to determine demographic features, concomitant disease, disease severity, polysomnography (PSG) characteristics and non-motor symptoms (NMSs).
Of the 239 patients, 66 (27.62%) had an AHI score ≥5, including 14.2% (34/239) with mild, 6.7% (16/239) with moderate, and 6.7% (16/239) with severe sleep apnea. The binary logistic regression analyses indicated that age and male gender were risk factors for OSA, while rapid eye movement (REM) sleep disorder (RBD) and higher Levodopa equivalent dose (LED) were protective factors for OSA. PD-OSA patients had higher Epworth Sleepiness Scale (ESS) scores than those of PD-non-OSA patients. No differences were found for other NMSs between groups.
Our data suggest that OSA in PD was lower in patients with RBD and higher LED. RBD and higher LDEs were significant protective factors for OSA in PD. OSA in PD was increased with age and male gender. Age and male gender were risk factors for OSA in PD. OSA can aggravate excessive daytime somnolence in PD patients but is not associated with other NMSs.
我们的目的是探讨帕金森病（PD）合并阻塞性睡眠呼吸暂停（OSA）的临床特征，探究OSA与PD特征之间的相关性，并确定PD患者中OSA的独立预测因素。
总共239例PD患者根据是否存在OSA（呼吸暂停低通气指数（AHI）评分≥5）分为两组（PD-OSA组与PD-非OSA组）。在对睡眠呼吸暂停状态不知情的情况下，参与者接受了广泛评估，以确定人口统计学特征、合并疾病、疾病严重程度、多导睡眠图（PSG）特征和非运动症状（NMSs）。
在239例患者中，66例（27.62%）的AHI评分≥5，其中轻度睡眠呼吸暂停患者占14.2%（34/239），中度患者占6.7%（16/239），重度患者占6.7%（16/239）。二元逻辑回归分析表明，年龄和男性性别是OSA的危险因素，而快速眼动（REM）睡眠障碍（RBD）和较高的左旋多巴等效剂量（LED）是OSA的保护因素。PD-OSA患者的爱泼沃斯嗜睡量表（ESS）评分高于PD-非OSA患者。两组之间的其他NMSs没有差异。
我们的数据表明，RBD患者和LED较高的PD患者中OSA发生率较低。RBD和较高的LED是PD患者OSA的重要保护因素。PD患者的OSA随年龄增长和男性性别而增加。年龄和男性性别是PD患者OSA的危险因素。OSA可加重PD患者白天过度嗜睡，但与其他NMSs无关。
